Anthrobotanica New Patient Enquiry Form

The following form will allow you to better understand how we work with patients.

We also want to learn more about your health concerns and background so we can check that we are the right fit for you before we arrange a 15m call with you.

To ensure you meet the basic requirements of becoming a new patient, please fill out the below questions and provide your contact information.

We provide consultation in-person in London and online via telemedicine, both via Anthrobotanica and HHCA. Are you interested in a consultation in person or online?In-PersonOnline Clinic

Are you under the care of a GP/Primary Care Physician?YesNo

What Package/Option are You Interested In?UltimateStandardBredesen60m Health MOT

Name (required)

Date of birth

Your Email (required)

Subject

Best Telephone Number

Best Times and Days to Reach you

Top 3 Health Concerns

How Did You Hear About Us?

Marketing Permissions

Anthrobotanica Limited may use the information you provide on this form to be in touch with you and to provide updates and marketing. Please let us know all the ways you would like to hear from us:Email & Phone
You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at info(at)anthrobotanica.com. We will treat your information with respect. For more information about our privacy practices please visit our website. By clicking below, you agree that we may process your information in accordance with these terms.